medical research

As health care reform rages through our government, a new and interesting approach to medicine is making it’s appearance as an alternative to making house calls. Coined by the American Academy of Pediatrics in 1967, medical homes are systems that provide around the clock access to care using a team of professionals – for example a physician, a nurse practitioner, a dietician, a social worker, and a pharmacist – to cut down on medical costs and improve access to treatment. Using a series of computerized records and electronic communications methods, medical homes help patients get specialty care when they need it and keeps careful track of treatments and progress. For doctors and health care professionals, the system is seamless and easy with contact and access to records always at hand.

According to the New York Times, there are now medical homes in more than a dozen states, many of them serving Medicaid patients. Their proponents say they save money because they focus on prevention and prompt attention to emerging problems, which can prevent costly complications. Some major health insurers are also testing patient-centered medical homes. The medical home concept has also won the support of the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Physicians and the American Osteopathic Association, among others.

Yesterday the World Health Organization (WHO) declared the first pandemic to hit in over forty years. The H1N1 virus, also known as the Swine Flu, has how reached a Phase 6, the highest level, on the WHO’s infectious diseases alert.

So far, the H1N1 or swine flu pandemic this year has accounted for 27,737 laboratory-confirmed cases and 141 deaths, although health officials believe many times that number have been infected but have not been tested because their disease was mild. In the US alone, there have been more than 13,000 cases and at least 27 deaths. A normal seasonal flu outbreak kills about 250,000 to 500,000 people worldwide.

The WHO and its supporters are now hoping that pharmaceutical companies will move faster toward the release of a vaccine against the new virus. The announcement will also have more impact on many impoverished countries, freeing up additional funds for treatment and prevention and helping to make stocks of antiviral drugs more readily available.

According to the World Health Organization, about 1.8 million people die worldwide each year from tuberculosis (TB) and a third of the world’s population are infected. In addition, of the 9 million new TB cases annually, about 490,000 are multiple-drug resistant TB or MDR-TB and about 40,000 are extensively drug resistant or XDR-TB. However, according to new research, an experimental treatment could help in treating resistant TB, delivering results that are up to five times more effective than current methods.

According to the study, funded by Johnson & Johnson, drug TMC207, if added to a standard cocktail of five other TB medicines, cleared traces of the tuberculosis bacteria in the sputum of 48 percent of the volunteers after eight weeks. Only 9 percent of patients given the five older drugs alone showed that type of improvement. TMC207 is now being billed as the first new tuberculosis drug in 40 years. It works by interfering with the enzyme ATP synthase, which the bacteria need to store energy.

“The development of TMC207 represents an important advance in the chemotherapy of tuberculosis,” said Clifton Barry of the National Institute of Allergy and Infectious Diseases in Bethesda, Maryland in a recent commentary about the new drug. It represents “a new class of drugs that increase the therapeutic options for patients who have multidrug-resistant or extensively drug-resistant tuberculosis, for whom treatment options are often sparse, largely ineffective, and often highly toxic.”

According to the Triangle Business Journal, United Therapeutics Corp. has won U.S. Food and Drug Administration approval to sell the drug Adcirca for the treatment of pulmonary arterial hypertension. Adcirca is a prescription medicine used to treat PAH, a life-threatening disease that constricts the flow of blood through the pulmonary vasculature. Adcirca contains the same active ingredient as Cialis (tadalafil), which is marketed by Eli Lilly & Company to treat erectile dysfunction in more than 100 countries.

The American Lung Association says pulmonary arterial hypertension can cause shortness of breath, chest pain and eventually heart failure when left untreated. There is no cure, but research continues into treatment and management options for those who may suffer from it. The disease is often linked to other conditions such as heart or lung disease, infection with HIV, and autoimmune disorders.

The exciting part of this FDA approval is that this new drug could change the way that erectile dysfunction and hypertension are treated in tandem, especially in demographic males who may suffer from both. Physicians will be watching to see what other drugs may come into play to treat two separate health issues effectively.

A unique new institute will look for ways to treat rare and neglected diseases and take the first and riskiest steps toward bringing new drugs to market, U.S. health officials said in a recent report.

According to Reuters news service, the government has provided support for several years to start the Therapeutics for Rare and Neglected Diseases Program at the National Institutes of Health. The program will use taxpayer money to get drugs through the most costly and dangerous phase of development, known as the “Valley of Death” because so many fail there.

The goal is to treat those who suffer from rare conditions that lack treatment. A rare disease is classified as one that affects fewer than 200,000 Americans, and NIH estimates there are about 6,800 of these conditions. Out of this number, only around 200 have treatment.

“Twenty-five to 30 million Americans suffer from rare or neglected diseases,” said acting NIH director Dr. Raynard Kington in a telephone briefing with reporters.

“We don’t know yet exactly which diseases this program will take on,” added Dr. Alan Guttmacher, acting director of the National Human Genome Research Institute.

Guttmacher also said the new institute would be opportunistic, pouncing on promising research studies, some of which may be funded by advocacy groups for rare diseases.

For more information on the Therapeutics for Rare and Neglected Diseases Program, visit: http://rarediseases.info.nih.gov/

During a recent web conference sponsored by Avalere Health, Ralph Brindis, incoming president of the American College of Cardiology, called for health care providers in all areas to increase their use of disease registries as to collect better data on quality and performance.

According to Brindis, the disease registries will “allow timely clinical data to be collected for performance-measure reporting.” He added that the registries would enable the industry to test “performance measures for many stakeholders before they are widely used or accepted.”
In addition, as more health providers use the databases, “the registries would be strengthened in terms of their participation within the community,” Brindis said. In the end, increased usage could help automate data entry and help health care providers avoid entering information into inefficient, multiple alternative systems. To put it simply, there needs to be something more unified.
Does your clinic or practice utilize disease registries? Why or why not?

According to a new report from the U.S. Department of Health and Human Services, health care in rural areas is facing cost and availability difficulties, making it an even more dire problem than in urban settings.

“Americans in rural communities have seen their premiums skyrocket and are finding it difficult, if not impossible to get the care they need,” says HHS Secretary Kathleen Sebelius. In addition, the findings also indicate that many rural residents pay 40% of their total health care costs, as compared with the urban share of one-third.

Rural Americans face higher rates of poverty, report more health problems, are more likely to be uninsured, and have less access to a primary health care provider than do Americans living in urban areas, the report indicates.

“In the current recession, the rural economy is losing jobs at a faster rate than the rest of the nation, and loss of jobs can lead to loss of health coverage. In particular, rural communities dependent on manufacturing have lost nearly 5 percent of their jobs since the recession began – and these are jobs that offer some of the best benefits,” says the report.

If you’re a rural health care provider, what steps are you taking to combat the issues raised in the HHS report? Is your practice making changes to make health care more affordable in the recession?

Regardless of the sphere in which it is implemented, new technology is something to embrace. It benefits businesses by increasing productivity and efficiency, and it benefits individuals by offering fun and exciting ways to finish personal projects. In general, technology has the potential to improve the quality of life for the user, and it can have ancillary benefits to others. Things are no different in the medical community.

A perfect example of technology’s positive effect on medicine is the computerization of medical records. Electronic medical records have made information more accessible and more accurate. Now, instead of sifting through seemingly endless shelves of folders and papers, one can simply look up patient information in a neat electronic database, and in critical medical situations, this can save valuable time. Additionally, adopting the electronic paradigm can save billions of dollars, which is further evidence of technology’s almost intrinsic facilitative capabilities.

Technology has immense benefits for medical science, so we can’t afford to turn it away. As a physician, it’s safe to say that you care a great deal about your patients, so you owe it to them to explore these new avenues.

According to recent reports from ABC News, a new and exciting breakthrough may have been made in the way we treat patients with broken or deteriorating bones. Forteo, a drug approved by the Food and Drug Administration to treat osteoporosis, works by activating idle stem cells in bones to rebuild more bone cells faster and effectively.

“I’ve never seen a medication do this before,” said professor J. Edward Puzas of the University of Rochester School of Medicine, who was involved in the clinical trial. “It is a way to turn back the clock for fracture healing.”

Researchers are saying that the drug could be an important breakthrough in treating hard-to-heal bone fractures faster and with less pain. Preliminary results of the early research projects found that of 145 patients with unhealed broken bones who were tested, 93 percent had significant healing and pain control after just weeks on Forteo. Already impressed by the drug’s performance, the National Institutes of Health have launched their own study on Forteo only using post-menopausal women with pelvic fractures as the subject.

“We have seen patients who have been bound to wheelchairs who could walk independently because this drug helped them heal their fractures,” said Dr. Susan Bukata of the University of Rochester Medical Center in an interview with ABC news.

By some estimates, as many as 300,000 Americans a year potentially could benefit from this treatment.

According to the American Public Health Association, National Public Health Week has been educating and celebrating issues that affect public health since 1995. Held during the first full week of April, National Public Health Week is an excellent opportunity for communities across the country to recognize the contributions of public health professionals in their area, as well as to further advance the goal of having a healthier community for years to come.

While most countries outside the US lack in the amount spent on health care each year, the United States still suffers from problems that affect the overall health of its people. According to the American Public Health Association:

- A baby born in the United States is more likely to die before its first birthday than a child born in almost any other developed country.

- U.S. life expectancy has reached a record high of 78.1 years but still ranks 46th — behind Japan and most of Europe, as well as countries such as Guam, South Korea and Jordan.

- The US is among the top 10 countries that have the most people with HIV/AIDS, and it is estimated that one in 20 residents in the nation’s capital are HIV-positive.

- Disparities persist with ethnic minority populations having nearly eight times the death rate for key health conditions, such as diabetes, than that of non-minority populations.

Start pushing for progress in your community and support the works of National Public Health Week. For more information, visit NPHW.org.